CAJ | 학술논문

目的：探讨舒芬太尼复合地佐辛对治疗结核性脓胸患者在开胸术后的自控镇痛(PCIA)效果，分析是否具有临床实用的价值。方法回顾性分析2014年1月至2015年9月期间共113例结核性胸膜炎、脓胸患者资料，按照随机原则分为两组，其中对照组56例在开胸术后采用芬太尼进行镇痛，而另57例观察组患者则是采用舒芬太尼进行术后镇痛，就两组患者的在术后第2h、第4h、第12h、第24h 以及48h 时的视觉模拟评分（VAS）、视觉模拟疲劳评分法（VAFS）、镇静评分、不良反应发生率进行详尽对比。结果观察组患者在术后2h、4h、12h、24h 及48h 的 VAS、VAFS 评分均明显低于对照组，差异显著(P<0.05)；同时观察组患者在各个时间段内镇静评分均要高于对照组，差异显著(P<0.05)；对照组术后不良反应发生率是7.14%(4/56)，观察组不良反应发生率则是8.77%(5/57)，无显著差异(P>0.05)。结论通过应用舒芬太尼复合地佐辛对结核性脓胸患者行开胸术后的自控镇痛(PCIA)效果要明显优于芬太尼镇痛效果，且用药相对安全有效，无明显严重不良反应。
목적：탐토서분태니복합지좌신대치료결핵성농흉환자재개흉술후적자공진통(PCIA)효과，분석시부구유림상실용적개치。방법회고성분석2014년1월지2015년9월기간공113례결핵성흉막염、농흉환자자료，안조수궤원칙분위량조，기중대조조56례재개흉술후채용분태니진행진통，이령57례관찰조환자칙시채용서분태니진행술후진통，취량조환자적재술후제2h、제4h、제12h、제24h 이급48h 시적시각모의평분（VAS）、시각모의피로평분법（VAFS）、진정평분、불량반응발생솔진행상진대비。결과관찰조환자재술후2h、4h、12h、24h 급48h 적 VAS、VAFS 평분균명현저우대조조，차이현저(P<0.05)；동시관찰조환자재각개시간단내진정평분균요고우대조조，차이현저(P<0.05)；대조조술후불량반응발생솔시7.14%(4/56)，관찰조불량반응발생솔칙시8.77%(5/57)，무현저차이(P>0.05)。결론통과응용서분태니복합지좌신대결핵성농흉환자행개흉술후적자공진통(PCIA)효과요명현우우분태니진통효과，차용약상대안전유효，무명현엄중불량반응。
Objective To investigate the effect of correlation between the sufentanil composite ground with sheen in the treatment of tuberculous pyothorax patients controlled analgesia (PCIA) after an open heart surgery , and analysis whether it has clinical practical value. Methods Aretrospective analysis about 113 patients with tuberculous pleurisyin during January 2014 to September 2015, in accordance with the principle of random divided them into two groups, one is control group which included 56 cases in thoracotomy with fentanyl for postoperative analgesia, and another one is observation group with 57 patients which is using sufentanil for postoperative analgesia. Carefully compared the visual analogue scale (VAS), visual simulation fatigue evaluation method (VAFS), sedation score, and the incidence of adverse reactions of the two groups in the 2 h, 4 h, 12 h, 24 h and 48 h after surgery. Results The VAS, VAFS scores of the observation group of patients in the 2 h, 4 h, 12 h, 24 h and 48 h after surgery were significantly lower than that of the control group. There was a significant difference(P<0.05); At the same time each period sedation scores of the observation group of patients were higher than those of the control group. There was a significant difference (P<0.05); The incidence of adverse reactions of the control group was 7.14% (4/56), and the incidence of adverse reactions of the observation group was 8.77% (5/57), so there was no significant difference(P>0.05). Conclusion Through the application of sufentanil composite ground with sheen to the patients after the open chest surgery, we can see tuberculous pyothorax self-control analgesia (PCIA) effect is superior to fentanyl analgesia effect, and the medicine is relatively safe and effective without serious adverse reactions.